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Indian Journal of Community Medicine

Quality of records for Maternal and Child Health services at subcentre level in a rural block of Rohtak

Author(s): Letter to Editor: Quality of records for Maternal and Child Health services at subcentre level in a rural block of Rohtak

Vol. 32, No. 1 (2007-01 - 2007-03)

The Health Management Information System provides information to support planning and control functions of the managers and help them in decision making. In 1999, under Ninth Five Year Plan speedy operation of HMIS (version-2) was implemented throughout India which is again computer compatible w.e.f. 01-04-991. Health workers male and female, who make sub-centre team have been trained and given a set of 13 registers to record health information2.

The present study was conducted in the block Lakhanmajra which is the rural field practice area of Pt. B.D.Sharma PGIMS, Rohtak. 20 functional subcentre during the year 1998-99 were selected. The study design was crosssectional. 400 mothers i.e. 20 mothers from each subcentre having children 1-2 years of age (i.e. born 1998-99) were selected by systematic random sampling technique from birth register of subcentre.

For assessing the quality of health information 10 elements of maternal and child care services were chosen, which were number of living children, date of birth, past obstetric history taken, number of ANC checkups, TT doses, IFA tablets, delivery conducted by, number of PNC checkups, family welfare method used and immunization of child.

A scoring system was developed for each element. First hand information generated from clients was matched with record maintained by workers and if the information generated from client matched with the record, a score of one was given and for unmatched information a score of zero was given. The scores were added for all elements & graded on following scale: 0-5 score was poor; 6-8 good & 9-10 score was excellent. The data collected was analyzed using suitable statistical tests.

Out of 10 elements of record for MCH services reviewed for quality, information for only 1(10%) namely TT doses was correctly recorded in more than 80% cases. Record for postnatal visit and contraception was not available for more than 60% clients.

As many as 59% of records relevant to the essential components of maternal and child health services were graded as poor quality & 39.0% and 2% of the records were categorized as good and excellent respectively. Similar observation were made by ICMR multicentric intervention study (1989-1992)3. Correctness of records about immunization, attendant at the time of delivery, PNC, & contraception was 66%.60.5%,14.2% & 27.5% respectively.

This result of immunization is similar to the finding of NFHS-II for Haryana State4.

Hence as a matter of policy a single service register or at the best two registers need to be evolved for preparation of consolidated information from recorded data. Maharashtra introduced “Family Health Card” which replaced all registers.

Basic training of workers and their continuing education should enable the health workers to develop the skill of handling data, its analysis and appropriate actions and decisions based on the data.Mechanisms like joint working of anganwadi and subcentre, under one roof (integrating sub centre and anganwadi function), joint survey, joint meetings at sector level and involvement of ICDS in RCH annual action plans at subcentre level can go a long way to improve the quality of records and services. Joint training and continuing education of functionaries can enrich the quality of data collection and its appropriate use subsequently.

References

  1. Planning Commission. Ninth five year plan 1998-2002. New Delhi: Planning Commission GOI; 1998.
  2. Government of India. Health Management Information System (Version-2.0). Subcentre registers and reporting formats (Model). New Delhi: MOH & FW GOI; 1992.
  3. ICMR. Improving the quality & coverage of maternal & child health and family planning services at primary health centre level. ICMR Task Force Study. New Delhi: ICMR; 1993
  4. International Institute of population sciences & ORC Macro. National Family health survey 1998-99. Mumbai: IIPS/ORC Macro; 2002.

R Verma: Department of Community Medicine, PGIMS, Rohtak
S Prinja: School of Public Health, Department of Community Medicine, PGIMER, Chandigarh
E-mail: [email protected]
Received: 19.08.05

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